The repair of an obstetric anal sphincter injury following the birth of a baby requires skill, experience and care. An incompetent or inadequate repair can leave the new mother with a lifetime of debilitating bowel problems.
Factors in a perineal tear repair
A number of important factors need to be taken into consideration when a new mother requires repair to a perineal tear. These include the skill of the relevant professional, the nature of the materials to be used and the type of techniques to be used.
Severe obstetric anal sphincter injuries are complex injuries which can impact on different areas of the anus and, consequently, require a variety of techniques to repair.
3rd and 4th degree tears can cause damage to the following areas:
- The external anal sphincter only
- The internal anal sphincter as well as the external sphincter
- The anal mucosa (the lining of the internal anal canal) as well as the sphincter muscles
- A rectal buttonhole tear damages the anal mucosa but not the sphincter
It is for this reason that a skilled and experienced medical professional is needed to undertake the surgical procedure.
Techniques for repair
The Royal College of Obstetricians and Gynaecologists makes clear the need for very specific techniques according to the nature and location of the injury:
An experienced physician should know that these different types of damage require different techniques for repair in order both to achieve the most effective repair but also not to put pressure on the repair leading it to break down at a later date.
For example, where the external sphincter has been partially torn, an end-to-end suturing technique should be used, whereas with a full thickness sphincter injury, an overlapping suture technique could be used.
Appropriate materials for repair
It is important that materials appropriate to the type and location of damage are used in order to avoid irritation and discomfort.
What might be appropriate material to use for repair of the external anal sphincter may not be suitable for an internal anal canal repair.
It is important that the surgeon uses the correct materials to avoid long-term problems developing at the repair site.
Failure of repair
Where the repair of an obstetric anal sphincter injury is incompetent, the repair may break down and start to cause problems.
Where the repair does not cover the entirety of the injury, the woman may also continue to suffer problems.
I t is possible that a fistula may develop between the anus and the vagina exacerbating any existing problems.
As a consequence the woman may begin to experience the following symptoms:
- Faecal incontinence or urgency
- Wind incontinence
- Leakage of wind or faeces via the vagina
- Repeated infections of the perineum
- Discomfort during sexual intercourse
Medical negligence
If you are experiencing significant, long-term symptoms due to a failure to repair your severe perineal tear effectively, you may be able to make a claim for compensation.
Contact us to discuss your situation with a specialist medical negligence solicitor with expertise in perineal tear claims.
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If you, or your family member, has suffered a birth injury tear, please call us now for free, no obligation advice on 0800 234 3300 (or from a mobile click to call 01275 334030) or complete our Free Online Enquiry.